Blood vials for blood test

Blood test costs can vary widely. Whether it’s a complete blood count (CBC) or comprehensive metabolic panel (CMP), it can cost a little or a lot. We’ve heard as low as $5 and as high as $401 for simple tests.

The sticker price may be shockingly high — and the cash price can be surprisingly low. No matter where you go, lab charges can be the most expensive part of a medical experience, regardless of whether you have insurance. Hospitals tend to be more expensive than other providers.

Blood testing may be one of the fastest-changing sectors of the health-care marketplace, and a sector where there’s the most disruption.

Need a CBC (complete blood count) test? It can cost you almost nothing, or a hefty sum. One diagnostic center in Hoboken, N.J., charges $10, while another lab in Brooklyn bills $117 for the same lab work. (Here’s our page of results for a CBC blood test in the New York area; here’s a list of prices for a CBC blood test in the San Francisco area. Here’s Los Angeles pricing, and here’s Dallas pricing.

How much does a CMP (comprehensive metabolic panel) blood test cost? It can cost less than $20 or more than $100 for cash or self-pay customers. In San Francisco, the range is from $19 to $273 for cash or self-pay customers.

Here is the New York list of results for the cost of a CMP blood test; here’s the San Francisco one.

Prices can vary widely. Is the provider in network? Have you met your deductible? Are you being charged the full rate? We also call it the “sticker price,” the Chargemaster price, or M.S.R.P. (for manufacturer’s suggested retail price, as in electronics sales); others call it the “rack rate.” Because in the health-care marketplace the sticker price is often paid only by uninsured people, it’s smart to ask; but you might also be interested to know that the “negotiated rate,” the price the insurance company pays for it can be considerably less. Here’s a blog post about a lab bill for which the charge was $401, but the negotiated rate was $24.80.

You may need a doctor-ordered prescription to get blood drawn, again depending on the state, but there are no rules about how much labs can charge for it. So, if you’re uninsured — or, yes, if you’re insured — know before you go. Also, many doctor’s offices can do some simple blood tests. And you might do better by putting away your insurance card and paying cash.

We currently list cash or self-pay prices for four fairly common tests: CBC (complete blood count), CMP (comprehensive metabolic panel), TSH (thyroid-stimulating hormone) and a cholesterol or lipids test. If you want another kind of test, you might be able to get a sense of pricing from what’s here. Also, there are many variations: CBC with differential? TSH alone or a full thyroid panel?

There are blood test online voucher options

There are also some on-line voucher options that we can’t uniformly access here in New York — as explained in this blog post, about ways to order lab tests at a discount.

The way it works: you contact the clearing-house company online, tell the test you want, pay up front, and then they send you to a participating lab.

State regulations may apply for availability.

If I was thinking about using an online voucher option, I’d be careful to do my homework first.

Examples: healthlabs.com or Quest Direct. Others: directlabs.com, which will take your order and apparently send you to another lab, like Quest; or AnyLabTestNow, a franchise operation that seems to have a limited number of locations.

Another is Everlywell,  a fairly new entrant. On the other hand, YourLabWork seems to have a lot of typographical errors on its site, and offers a range of test bundles and a few remarkably robust prices (CBC blood test for $30.) It says not available in New Jersey, New York, Maryland, Rhode Island and Arizona.

If you’re getting a blood test soon…

    • For both insured and uninsured people, it’s important to ask before you go — what is this blood test going to cost me?
    • Inquire about available discounts. At one Brooklyn-based laboratory chain, uninsured customers qualify for a 50%-off coupon upon request — but you have to ask for the coupon, we were told during our survey. Another lab charges uninsured patients nearly 70% less than clients with insurance.
    • One laboratory in Connecticut told us they bill uninsured patients based on the test and the client’s circumstances, offering income-based discounts. But one of the big things we learned is that if you ask for a cash or self-pay rate, you can find low prices.
    • There are many variations: CBC with differential? TSH alone or a full thyroid panel? Ask.
    • How will you get results? Will they be sent directly to your doctor? Do you want to see the results yourself? Ask up front.
    • Ask if there are any extra costs: some places charge a “draw fee” or a “venipuncture fee.” If you are having four tests, even if it’s only one needle, you might get charged four times. Ask. “Are there any other fees or charges?”
    • Accreditation is important. Without it, your tests might not be accurate or valid. Two organizations that accredit labs: College of American Pathologists (CAP) and Clinical Laboratory Improvement Amendments (CLIA).

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...